Answers to Questions about Chiropractic:
Am I Entitled to a Copy of My X-rays?

Samuel Homola, D.C.

Question

After suffering from acute lower back pain for almost two months, and seeing very little improvement with "conventional" treatment, I went to a chiropractor who was offering a free consult.

In my third week of treatment now, I feel the rate of improvement increasing over what it was beforehand. Unfortunately, this is also the time that my DC has started pressuring me to subscribe to the "subluxation theory" and "chiropractic wellness." That makes me very uncomfortable—especially since in the last session he actually argued with me about, for example, the "nerve system" being in control of things like histocompatibility, and blood component response to simple cuts. This seems so goofy to me that I have lost my confidence in this guy, despite the fact that he seems to be helping me.

My specific question has to do with the chiropractic x-rays. He did the full-spine, standing x-ray in his office. I was surprised to see, without any prompting from him, my spine curving sharply to the left (as seen from the back) around L4 to L6. He zeroed in on this, and identified it as the likely cause of my lower back pain. Again, he is only treating this specific area, and I do feel that it's helping.

Now I am seriously considering an evaluation visit to what you would call a "rational chiropractor," and would very much like to take my x-rays with me.

Do I have any right to use those x-rays to get a "second opinion" from another health practitioner, or will I have a fight on my hands if I even mention it? Or are the x-rays worthless to begin with? The only thing that seemed sensible to me, is the taking of the x-ray standing (with the effects of gravity, posture, and muscle action) versus lying down, which is how my "conventional" x-rays were taken.

The chiropractor is a "Gonstead" practitioner, if that matters.

Answer

Manual manipulation and other forms of physical treatment are often effective in relieving back pain. While it is possible that for a lumbar curvature to contribute to acute back pain triggered by strain or injury, a curvature is seldom the cause. Furthermore, structural curvatures cannot be changed by manipulation. Curves caused by muscle spasm will disappear when the pain and spasm subside. Treatment should be discontinued when the pain is gone, even if the curvature remains.

There is no logical reason to believe that regular adjustments will have any effect on general health or the body's ability to heal itself. It is certainly "goofy" to claim that manipulating the spine will speed the healing of cuts, and so on.

Full-spine x-rays have little diagnostic value. While it might be helpful to x-ray the spine in a standing position for accurate measurement of a curvature (and leg length), the x-ray should be centered over the painful area of the spine in order to avoid the distortion caused by a full-spine x-ray. A structural curvature will be evident when lying down as well as while standing. If x-ray examination is needed, regional examinations provide sharper views with less radiation exposure.

Health practitioners are generally required to provide a copy of their patient's x-ray films and other records upon request, although they are permitted to make a reasonable charge for them. Some permit their patients to borrow the original films. If your back pain persists, however, an orthopedist or other practitioner would probably disregard the full-spine x-ray and order films of the symptomatic area.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This article was posted on September 21, 2002.